Organization
DESERT/MOUNTAIN CHILDREN'S CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD POWELL PH.D. (ADMINISTRATOR)
(730) 242-6333
Entity
Organization
Contact information
Practice address
17800 US HIGHWAY 18, APPLE VALLEY, CA 92307-1221
(760) 242-6333
(760) 946-0819
Mailing address
17800 US HIGHWAY 18, APPLE VALLEY, CA 92307-1221
(760) 242-6333
(760) 946-0819
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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